Reply to Letter to the Editor by Kang-Auger G, et al.

In their letter, Auger et al. [ [1] Kang-Auger G. Ayoub A. Côté-Corriveau G. Letter to the editor regarding: comparison of trauma and burn evaluations in a pediatric emergency department during pre, early and late COVID-19 pandemic. J Pediatr Surg. 2023; https://doi.org/10.1016/j.jpedsurg.2023.03.008 Abstract Full Text Full Text PDF Scopus (0) Google Scholar ] suggested that a possible explanation for an increase in burn injuries noted in our study during the pandemic periods could be secondary to undetected child maltreatment especially in children 0–4 years of age. In an age stratified analysis, we noted that a higher proportion of children in the 0–4 age group sustained burns when compared to the older age groups during both the pre-pandemic and pandemic periods. There was no significant difference in the median total body surface area (TBSA) between the three age groups or in proportion of children with severe burns (>15% TBSA) between the pre-pandemic and pandemic periods. There were no significant differences in the proportion of children with burns secondary to child maltreatment during the pre-pandemic and pandemic periods (Table 1). We categorized injury mechanism as secondary to child maltreatment in only those patients classified as such by our institution's Child At Risk Evaluation (CARE) team. Hence, we could have underestimated the incidence of burns secondary to maltreatment. Table 1Comparison of burn injuries during the pre-pandemic, early and late pandemic periods by age stratification. Variable Pre-Pandemic n = 494 Early Pandemic n = 307 Late Pandemic n = 484 p value Burn injuries 0–4 years 301 (60.9%) 171 (55.7%) 261 (53.9%) 5–11 years 138 (27.9%) 103 (33.6%) 172 (35.5%) 0.14 12–16 years 55 (11.2%) 33 (10.7%) 51 (10.5%) Median TBSA (IQR)a TBSA: Total Body Surface Area. 0–4 years 1.00 (0.5,3.00) 1.50 (0.5,3.00) 1.25 (0.50,2.50) 5–11 years 1.00 (0.5, 2.00) 1.00 (0.5,3.00) 1.50 (0.50,3.00) 0.16 12–16 years 1.00 (0.25,2.00) 1.00 (0.25, 2.00) 1.00 (0.50,2.25) Severe burns (TBSA>15%) 0–4 years 8 (66.6%) 0 (0.0%) 5 (50.0%) 0.17 5–11 years 2 (16.7%) 3 (60.0%) 3 (30.0%) 12–16 years 2 (16.7%) 2 (40.0%) 2 (20.0%) Burns secondary to child maltreatment 0–4 years 22 (73.3%) 10 (90.9%) 8 (50.0%) 5–11 years 8 (26.7%) 1 (9.1%) 7 (43.8%) 0.13 12–16 years 0 (0.0%) 0 (0.0%) 1 (6.25%) a TBSA: Total Body Surface Area. Open table in a new tab